Montefiore in the News
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Montefiore in the News

January 24, 2020

If you're one of the many moms who've given birth during the height of respiratory syncytial virus (RSV) season, you're probably doing everything you can to keep your newborn healthy. Rising in prevalence during the fall and winter months, RSV is a virus that mimics a bad cold in older babies and children. But unlike a cold, RSV attacks the tiny airways of the lower respiratory system.

"For RSV in newborns, the degree of inflammation and mucus production can be substantial. This inflammation and mucus can cause blockage of the smaller airways in the lungs, making it difficult for these young infants to breathe," says Alyssa Silver, M.D., an attending physician at Children's Hospital at Montefiore in New York.

That's why RSV in newborns is much more dangerous than it is for older children. In fact, over 40 percent of hospitalizations from RSV occur in children under 6 months old, says Jennifer Marshall DNP, FNP-BC, a nurse practitioner at Avista Family Medicine in Erie, Colorado. Even more frightening, the Centers for Disease Control and Prevention (CDC) reports that RSV leads to 100-500 deaths in children under the age of 5 each year.

So what should you do if your infant does catch RSV despite your best efforts?

"Unfortunately, there is no magic medicine that makes RSV get better faster. The large majority of those with RSV need time and support through this illness," says Dr. Silver. Despite that, there are some RSV symptoms in newborns you'll want to be on the lookout for. If you notice any of the following symptoms in your baby, it's best to head to the emergency room immediately.


Never ignore any signs of breathing difficulty in an infant such as very fast breathing, using a lot of extra muscles to breathe, pulling at the neck, nostrils flaring in and out, or being able to see in between the ribs while breathing—called retractions, says Dr. Silver. These are all signs Baby is struggling to get enough oxygen intake, which is an emergency situation.

Fewer Wet Diapers Than Usual

Any infant who goes more than 6-8 hours without a wet diaper should see a physician as a warning sign of dehydration, says Dr. Silver. Unlike other common childhood illnesses, dehydration from RSV isn't caused by high fever or vomiting. Instead, it's a side effect of the difficulty Baby will experience when feeding due to the extreme nasal congestion that's common in RSV sufferers.

A Blue Tinge Around Lips and Fingernails

According to Dr. Silver, any bluish discoloration of the skin is worrisome. "These are signs that your baby may need oxygen or additional support with breathing and should be seen in the emergency room right away," she warns.


Apnea, or a period of time where your baby is not breathing, is a critical symptom in an infant under 6 months, says Marshall. Although this is one of the more common—yet terrifying—RSV symptoms in newborns (very young newborns may have pauses in their breathing for more than 20 seconds when they have RSV, according to Dr. Silver), it's still a cause for concern and should be evaluated promptly.

Poor Feeding

When it comes to RSV in newborns, they can become so severely congested that they're not able to complete a feeding. Dr. Silver says, "this can progress to the point that babies need either supplementation in their feeding with a nasogastric tube (from their nose to their stomach) or intravenous (IV) fluids." If you're struggling to get Baby to feed for more than a few minutes at a time, the first thing to do is monitor her diaper output. If she's not having wet diapers, she may not be receiving adequate nutrition, and a visit to the pediatrician is definitely warranted.